I have had non-purging bulimia and binge eating disorder in the past. I had disordered eating for many years as a teenager but the overt eating disorder only emerged after a crash diet. This is a common story: strict restriction hugely increases your risk of binging simply due to the physiological response to starvation. I was in the psychiatric system for my bipolar disorder and the psychologist I was seeing did a detour and treated my eating disorder pretty successfully. The fact that strict dieting (i.e. restriction) causes binging which causes compensatory behaviour was drummed into me and while I didn’t really believe the link before, I do now.

I went on a diet for the last three months of last year and I lost 23lb. I told myself I would do it slowly and not trigger my eating disorder. I had norovirus twice in the last month and my weight dropped much faster than my planned 1lb a week. I started getting urges to binge which gradually got overwhelming. I thought I would ‘pause’ dieting and deal with the urges to binge. I did not. I binged and compulsively overate (discrete episodes of eating very large amounts very fast feeling very out of control over a background of generally eating much more than I wanted to). I put back on all the weight plus 15lb over the next six months. This coincided with other medication changes so perhaps there was more to it than simply the eating disorder. I read Fairburn’s Overcoming Binge Eating which is the gold standard in self-help. Eventually, I wasn’t binging anymore and my urges to binge pretty much disappeared so I felt the eating disorder had abated again.

When I weighed myself and found out how much weight I had put on, I was so shocked. I felt crushed. Yeah, it was an over-reaction as in the scheme of things it is not that massive a deal. It’s not a death in the family or a diagnosis of terminal illness. But still, I had this drive that I couldn’t be that weight. It was unacceptable.

So I went on a diet again and here I am. I have lost weight faster than I originally agreed with myself (red flag) and I feel triggered to cut my calorie intake right down (red flag). I log everything I eat in an app pretty obsessively (red flag) and feel reassured by how in control I am (hahahhaaa). The statistics say that when I stop this diet, there is a 65-90% chance that I am will put the weight back on and a 33% chance that if I do, I will end up heavier than I started. I feel a mixture of hopelessness and hope. There is so little chance that I will be at an acceptable weight (and for me, that is not ‘thin’ but simply a BMI below 30) permanently but there is that little thought that maybe I will manage it this time.

I had been ridiculously depressed since the New Year, possibly as a side effect of a drug I’m taking for a physical health condition, after a three month mixed state/mixed episode/dysphoric mania. As depressions go, and I am a connoisseur of twenty-five years, it was pretty grim. My world restricted down and down as I stopped doing things. One of the things I stopped doing was showering very often.

When I was a teenager and lived with my parents, the only room in the house with privacy, or a lock, was the bathroom and so that’s where I self-harmed. I self-harmed for around eighteen months before I told anyone about it and it was very lonely. I would go into the bathroom for a shower, cut myself (three one night, four the next, to make groups of seven, fuck yes, I might be mad) and then shower watching the red water run down my skin and swirl at my feet. This continued for a few years. So a shower equals self-harm for me. I haven’t self-harmed in years now but the association is still there. I feel like when I am in the shower I am prey for my intrusive negative thoughts (in English, that means bad thoughts that force their way into your mind) and it crushes my mood. A shower also takes a lot of energy when you don’t have many spoons. Showers, not a fan.

When I was last well, and that was over fifteen years ago, I showered every day. The above still bothered me but I had enough resilience to overcome them. My ‘good periods’ since I stopped working are to shower every other day. If I have a shower in the morning (haha, afternoon) then I spend the rest of the day saying “at least you’ve had a shower” to myself in relief.

At my worst, I just don’t shower. I think the longest I went was over two weeks but two or three showers a month during a bad spell of depression would be typical. My severe depressions last months at a time.

What the fuck has all the banal detail in my showering habits got to do with insight? I have had a shower every day for four days and feel like I could be okay with that. So? I genuinely can’t tell sometimes when I’m ill. That will sound completely ridiculous to someone who hasn’t had lack of insight. This symptom plus this symptom plus this symptom equals this mood. I think people experience it differently but, for me, when I’m depressed it isn’t that I am ill that all these things are happening to me but because I am stupid and lazy and these things should be happening and the universe is functioning as it should. It is fair and right and entirely deserved. When I am manic, I simply disagree that things are as bad as other people say. They are simply wrong. If I am feeling magnanimous then they are simply misinformed if well-intentioned. If I am feeling paranoid (and I would never use that word or recognise it as that at the time) then they are deliberately trying to curtail or hurt me. All these scenarios actually happen to people and have happened to me so why don’t they count now I’m supposedly “ill”?

Showering is a proxy for me. I like to think that I always try reasonably hard to have a shower so the amount of effort is pretty constant over time. It is the other factors that vary (i.e. my mood) and those that determine whether I actually have a shower. So if I am not showering then I am depressed. No, I am just rubbish and pathetic this time and in a few months I won’t look back and think “you were depressed” and this is simply cause and effect; it is real this time. It doesn’t completely convince me but I allow the possibility that it’s not real this time. That opening of the possibility gives me a space that I wouldn’t have had.

So maybe I am well now. I feel fine, calm and somewhat positive. I’m even wearing makeup (oh no that’s a red flag proxy) and going out to meet friends (I have this drive to socialise, oh no that’s another red flag proxy) and I find it hard to get to sleep despite my antipsychotic (oh no) and I don’t sleep long but wake up raring to get going (oh no). These are all such little things and none of them appear in the diagnostic criteria. I can’t trust myself to tell what my mood is directly as fine can mean depressed, normal or manic in retrospect. But I can feel smell the wind.

I move in a week. I was offered a housing association flat. It’s very nice. The only thing I don’t like about it is that it is a bit further away from the area I would prefer to live in but that’s it and that’s not a huge deal. It’s a secure tenancy, my own place that I can’t be chucked out from at the whim of a private landlord, not a high rise, it has huge rooms, it’s on the first floor which is perfect, my new neighbours seem nice, the bathroom and kitchen are nearly new, the rent is so cheap and I’ve had it painted and put in new flooring so it looks great. I should be so excited and pleased but instead I wish it wasn’t happening. I can’t find any enthusiasm for it at all.

I shouldn’t be so ungrateful. I want this to be over and just stay in my little flat without having to go through any of this. I’m worried I’ll hate the new flat and it was unwise to put all this money into it. I’m worried that I’ve forgotten really important things that I will kick myself about and that people will laugh at me about. I’m stressed and tired. I feel like I am haemorrhaging money. I’m worried I’m going to regret all these decisions that I keep having to make.

I need a plan of what I still need to pack so I can work out if I can have a day off. Still to do:

hall cupboard

last CDs

eight kitchens cupboards and one drawer

stereo and TV

desk drawers

computer

clothes and shoes

lamps

pictures

Plan:

Thursday: get delivery, clean out fridge and microwave, hall cupboard, last CDs and one kitchen cupboard

Friday: take shoes to charity shop, go to supermarket, wash landlord’s dishes, four kitchen cupboards, get O to get boxes down from high cupboard

Saturday: clothes and shoes, pictures, lamps

Sunday: take clothes and shoes, pictures and lamps to new flat

Monday: three kitchen cupboards

Tuesday: stereo, desk drawers

Wednesay: last loads of washing, TV and computer, finish up anything left over

I’ll have to push some of one day into another day if I want a day off. Also need to get the cooker delivered one day which will be a wait down at the new flat plus should clean the bathroom. This is more than I thought oh god.

Kind of. I’m doing a lot better. Been going out and seeing people. The last few weeks have felt like they lasted a long time and that I have done things in a lot of the days. I write them down in my mood diary on my phone. In the months over the winter and spring, the days and weeks just blurred past and I didn’t even notice.

I’ve been feeling self-destructive and have thoughts about hurting myself and sometimes about killing myself. If I think about the future, I still go down the old path of thoughts where I end thinking that I have no choice but to kill myself and that I should just get on with it. But it’s not every day and the last time I had a few days of thinking I should kill myself I was also thinking “maybe I have PMS, maybe this is just PMS” which is actually pretty new for me. This all feels pretty new and kind of unsettling. I don’t think I know how to cope with a more normal mood. That’s frightening. I have been stuck in this pattern with my thoughts and feelings out of control for too long.

Some of the things I’ve been thinking about is to bruise myself visibly, on my face. It’s attention-seeking. I want people to notice that I’m still struggling with my thoughts. I want them to tell me it’s okay to still be rough even though it’s been going on for so fucking long and that they believe me. I don’t feel anyone would believe me. I don’t really know what to say about what is still wrong just now.

I have so many good things. I have a new support worker and they are medium to long-term (in my terms, don’t know what they call themselves) so I feel like something good and safe is starting now. I’ve only had three appointments with them and I can already feel it steadying me and keeping me going. I can’t even say what it is about them that makes me feel steadier but something is. I’ve got back in touch with some of my old friends and nobody has turned me away and rejected me. They’ve all replied and said it was good to hear from me. I feel like D is glad to see me though I still hear the thoughts of “she’s not really, doesn’t mean it, just saying it to be nice”. I’m spending a lot of time with my sister and she seems keen to see me. She’s been suggesting meeting up and I don’t feel like I’m making her do it. I just went outside to have a cigarette (that should count as a bad thing but fuck it, I don’t feel particularly bad about starting up smoking again other than the money) and it was so nice and cool and breezy. I was panicking about the heat-wave and thinking I’d never cope with it but I’ve been coping and keeping going, at least to some extent. I didn’t give in to the panic entirely. I’m not totally hating myself, just mostly ;-) I actually mean that, I have some thoughts that are nice to myself. They seem to come out of nowhere. I found some bras that fit and make my chest look better which makes me pleased. I was feeling really lonely about being in my flat alone but I spent some time with a L is his flat, just hanging out, and got bored and when I went home, I was pleased to be home. I appreciated having my own flat with just me in it. I am luckyluckylucky. But is that all, you are so pathetic.

I had an appointment with my CPN today. I tried to talk about what is still wrong but it felt like she kept changing the subject away from it. It feels like she didn’t want to hear it because it was her last day before going on holiday and she just wanted a chatty, cheerful appointment. I need to watch that. She’s not my friend, she’s my nurse. If I have bad things to say then she should help me say it. I shouldn’t have to be chatty and cheerful to please her. I was seriously suicidal a few weeks and was back with the crisis team so it’s not that unreasonable for me still to have bad things to talk about. I’m afraid of what this means. But I’m not panicking about it, I’m thinking “I will watch out for this, maybe I can sort it out if it becomes a bad situation”.

I’ve lived in my current flat for four years. I moved here after I split up with my ex-boyfriend. I was very ill, and the got worse, when we split up. I was in a city where I knew no one other than my ex-boyfriend and three hours travelling from the city I had lived before and wanted to move back to. It took me six months to find a new place to live and move into it. I was sleeping in the spare bedroom but was still having sex occasionally with my ex-boyfriend and he was still looking after me because of my illness.

I applied for benefits so I could get enough money to move out: deposit, first month’s rent, maybe a little bit of a cushion in case it took a while for housing benefit to start (had waited five and a half months for it a couple of years before). But I was turned down because they didn’t believe that I’d really split up with my ex-boyfriend and was still living with him ‘as if we were married’. I had stopped seeing the psychiatric services in the new city and stopped all my medication (except for some prn’s around the same time as I’d split up with my ex-boyfriend except for a social worker who tried to help me but said he couldn’t really do anything because I wanted to move to another city. I tried to contact this city’s homeless services but kept getting passed between two departments with both saying they weren’t the department to deal with me and I should contact the other. I stayed with my sister for a few days and she talked to them on the phone and couldn’t work out what to do either. The only suggestion I got was to go into one of the offices and ‘make a scene’ until one of them agreed to deal with me. My sister said she couldn’t come with me (something I still feel bitter about and should really get over or sort out with her). I could barely cope with travelling to see my sister and knew there was no way I was capable of ‘mak[ing] a scene’ so I gave up. Not seeing the psychiatric services or the homeless services while I was so ill and my life was such a disaster probably sounds like an incredily stupid decision but it wasn’t and I’d do it again looking back but my reason are another post.

I was an undischarge bankrupt too with the worst credit rating you can get and I was unemployed with no prospect of being well enough to go back to work any time soon. I felt a lot of shame about that (still do) and couldn’t face telling anyone about it. I thought that I had no chance of renting from a letting agency because I would fail the credit check and had no proof of income; every single one said ‘no DHSS’ or something similar. The DHSS hasn’t fucking existed for over two decades but the meaning was perfectly clear: no benefit scrounging scum. Private ads almost all said ‘no DHSS’ too and it turned out some landlords had access to credit checks too. I didn’t know that I could try to offer a guarantor and pay more month’s rent in advance to avoid the credit check and lack of proof of employment. So I thought I had to lie that I was employed and hope a landlord both believed my lie and didn’t credit check.]

I had pet rats who I wasn’t going to give up. They felt like the only thing I had left. So I need a landlord that didn’t mind pets or wouldn’t inspect too often. It’s actually not that difficult to hide pet rats and I’d done it for years in student accommodation despite having a 5′ by4′ by 3′ cage (happy ratties) for them.

Despite all these reasons/excuses for why I found it so difficult to get a new flat, the main problem was that I couldn’t make myself travel to the city I wanted to move back to and find a new flat. I was totally overwhelmed by my illness and by my situation and was paralysed by shame.

In the end, I only looked at two flats. The first was a nice flat but wanted a credit check. The second, where I live now, isn’t a particularly nice flat and is run down but the landlady didn’t ask for a credit check or proof of employment and didn’t do inspections. She gave me a short, illegal lease that included a clause that I had to fix the flat’s white goods if they broke down and other crap like that. It’s an expensive flat too. But my rats were safe and I was safe and it was done finally. It’s only in the last year or so that I’ve realised what a desperate situation I was in and that getting this flat was a huge achievement. I made myself safe again. I got the benefits sorted out and had enough money. Safe safe safe. That six months is definitely near the top in my list of awful experiences.

I orginally planned to stay in this flat for about six months and find a nicer, cheaper flat. Haha-fucking-ha, here I am four years later, mainly due to apathy and shame. I’ve only finally applied to housing associations this year as the thought of explaining my situation to whoever I had to apply to felt impossible. I knew I’d sit in front of the person from the housing association and not be able to stop crying. I asked a couple of people to come with me to the housing associations and they agreed but I never actually made solid plans to go with them.

I hope writing all this is cathartic because I feel like shite now, typing it all out. It’s all pathetic excuses and I should just get a fucking grip and get on with it.

Now I need to make a plan about what I want to do next. I actually have a few options but I can’t work out what I want (which is something I can’t seem to do for anything). So here are my options:

1) stay in my current flat and wait for a ‘nice’ housing association flat

{} advantages:

* I’m safe here and while it’s expensive, I can pay the rent every month without going into debt and still keeping my (small) savings

* avoid the stress and cost of moving especially since I would want to move again into a housing association flat

* new lease is a standard lease from the government and protects my rights and gives me a two month notice period

* could spend this summer being well and building myself up without taking up this time with moving

* could change my mind about a private let later

{} disadvantage:

* most expensive option and has the most uncertainly about being able to afford the rent with the next round of benefit changes

* would spend my time on the waiting list in a flat I don’t like

* will take a long time, probably years

* have to apply to the rest of the housing associations (slacker)

2) stay in my current flat and wait for a multi-storey housing association flat then hope I can move into a ‘nice’ housing association flat

{} advantages:

* my own flat! I could paint and do what I want, have all my own furniture just as I like it

* I’m safe in this flat (god, it makes me cry every time I type safe) and I’d be super-safe in a housing association flat

* could have pet rats again (most common cause of pets ending up in shelters is because people get pets when their lease say ‘no pets’ and the landlord finds out, I’m not risking that again)

* I don’t know for sure how long I would be here but guessing only months

* would probably get a two bedroom flat (which I can afford) because of the severe shortage of one bedroom flats

* could spend this summer being well and building myself up without taking up this time with moving

* could change my mind about a private let later

* could move out of the multi-storey flat if I hated it and back into a private let then reapply to the housing associations

* not worried much about the stigma of living in a multi-storey or about the rumours that there is a lot of ‘trouble’ in them, walked around the building and the area looked nice and green and well maintained

{} disadvantage:

* big assumption that I could tranfer to a new housing association flat though the housing officer did say I could

* guilt of trying to ‘game’ the system by asking to transfer to a new housing association flat

* could be waiting years for a transfer, don’t know if I could apply to other housing associations too but bet I would start again at the bottom of their lists (I could just ask and find out for sure)

* couldn’t have a dog

* could hate being in a multi-storey and find it much more difficult than I thought

* risk of jumping, support worker thought it was a really stupid and risky idea

* housing association might not let me get a multi-storey flat in case I jumped (though think I could have a good chance of persuading them)

3) move into another private let and wait for a housing association flat (pretty much same situation if waiting for a ‘nice’ flat or a multi-storey flat)

{} advantages:

* would be spending my time on the waiting list in a nicer, cheaper flat

* turns out that the standard notice period for a short assured tenacy is two months, not one month, (how did I not know this until last week?! my new lease has this) and I could only consider flats with that notice period

* cheaper rent, could increase my savings and less potential problems with the next round of benefit changes

{} disadvantage:

* don’t know how safe I would be in a new private let

* new private let might be a disaster and I’d have to move again

* don’t know how long I’d have to stay in these new private let(s)

* stress and cost of moving at least once before moving into a housing association flat

* can’t change my mind and come back to my current flat

Is that all my options? It doesn’t look so confusing written down and I’m definitely leaning towards staying in this flat until a multi-storey flat comes up. The housing officer did tell me that getting a housing association flat isn’t supposed to be an ‘aspirational move’. The most important thing is getting my own flat. That would be so good. So fucking good! So safe!

Yep, I think I’ve decided: staying here until a multi-storey flat comes up. I’ll keep on thinking about it and maybe I’ll come up with more reasons. But I think they key things are that I would have my own flat and that I could change my mind about getting a new private let if I wanted to but I couldn’t come back to this flat if I moved to another private let.

I don’t go to my GP very often, about once or twice a year, and it’s usually for physical health problems. Some people who have chronic mental illnesses have regular appointments with their GP about their mental health. My CPN has asked me a few times over the years “when are you next seeing your GP?” as if I was going to regular appointments so I wonder if it’s expected. My GP hasn’t suggested it to me and I’ve not asked him.

I’m kind of ambivalent about having regular appointments. I think it could be useful for my GP to know what was going on with me and keep track of things assuming he wants to do that. Also assuming the GP and the psychiatry services aren’t communicating well already. But it’s not like the GP is going to be changing any of my treatment. The whole point of going to a specialist, a psychiatrist for me, is to have them take over the specialised care of more complicated or long-term illnesses even though the GP is still required to keep co-ordinating the different parts of the care or at least make sure co-ordination is happening. I’m happy with the co-ordination that is going on and while I might be missing some of the subtleties that are happening, it makes no difference to what actually happens to me as far as I am concerned. Some people will want to be more involved and know exactly who, what and when. That was me ten years ago but not anymore. I don’t know if it would be useful for me to have regular appointments with my GP just to talk about my mental illness. I’m crap at talking about it so maybe more practice would be a good idea but would ten minutes once a month or whatever actually make any difference? I suppose it would be another excuse to get me out of the house which I could do with. These reasons are the ones I’ve thought about whenever the idea of regular appointments with my GP has come into my head, which isn’t often.

About a week ago, the backs of my thighs started getting sore (bear with me, I have a point… in four paragraph’s time) as if the muscles or something were too tight. It got worse so by Friday I couldn’t sit for more than a couple of minutes without having to get up. Fuck me, I never realised how much I took for granted being able to sit on a toilet seat. The pain was from my ankles right up into my bum in both legs. It wasn’t continuous and it moved up and down over hours. When I was lying down or walking, it felt like cramp or tightness with some throbbing and prickling or spiky feeling. If I walked more than about half an hour it got more and more painful and my legs started to feel weak. When I was standing still or sitting down, it felt as if a pole about an inch thick was being pushed into the backs of my legs. It would throb and get sharp pains so that I felt like I had to move or lie down. It felt painful whenever something even softly pressed into my legs. This was all only at the backs or slightly to the sides of my thighs and calves. When I looked in the mirror, there was a little bit of varicose veining in my right calf but none anywhere else. But I could see the raised, swollen ‘poles’ that were around veins I think. There seemed to be blue-ish lines anyway. The swollen bits were a good bit thicker than the veins and mostly I couldn’t see the actual vein. The swellings felt hot and springy.

So I asked Drs Google and Wikipedia who seemed pretty confident that it was phlebitis (not thrombophlebitis) and not anything dangerous like a DVT or whatever. I was thinking that since it was happening on both legs and from ankle to arse that it might be something systemic rather than a local problem. Meaning I might be able to palm it off on my medication! But to be serious for a split second, a medication side-effect made sense since the symptoms were so wide-spread.

I saw my CPN two days ago and I asked her to look at my legs and she didn’t see varicose veins other than the one little bit and could see the new swelling of whatever the fuck was happening. I said I thought it was phlebitis. She said perhaps I was right but perhaps Drs Google and Wikipedia wouldn’t mind if I saw a real doctor and perhaps I should go to my GP. I’d need a definite diagnosis to find out if it was a medication side-effect for a start. She also got hold of my psychiatrist who said he didn’t think it sounded like any of my medication was to blame but that I should go to the GP as I might need antibiotics. Drs Google and Wikipedia hadn’t mentioned antibiotics.

Of-fucking-course by the time I’d actually got to the GPs yesterday my legs were a lot better and there wasn’t much pain or swelling left by the time I saw the locum. She said it was definitely not anything serious and wasn’t sciatica, thrombophlebitis or DVT but it might be myalgia from the risperidone. It’s going away and as long as it goes away completely then I think that’ll be the end of it.

This is a very long story to say that it was actually really upsetting for me to go to my GP even though I was almost certain she’d say I didn’t have anything serious and that whatever it was would go away by itself. I didn’t want to go and made a lot of excuses to myself when this first started. I got pretty frightened at one point thinking that perhaps whatever it was that was happening might be permanent and that I would be stuck with it. I felt ashamed at the thought that maybe I’d damaged my body permanently. I felt better once I convinced myself it was only phlebitis but I shouldn’t have done that because I’m not a doctor and can’t diagnose myself. I even wondered if perhaps I had a DVT and if I’d been thinking that then I should have phoned the emergency GP or whatever it is you do then. I would have had to ask Dr Google again. This is all because I keep thinking of what will happen if the doctor starts tearing me a new one because I am fat. This isn’t some irrational fear: I’ve had doctors and nurses be horrible to me about being fat. Once I went to the nurse at my GP surgery to get my blood pressure checked (it has been high on and off ever since I had the problems with venlafaxine) and she did that but insisted on weighing me even though I said I didn’t want to be weighed. She was very disapproving and plain fucking horrible and I came out of that appointment wanting to take a machete to my body and cut the fat off it. That lasted for weeks and even made me think that I should let my eating disorder back into my life so that at least I could lose weight. It’s not just the horrible things that doctors and nurses can say that worries me, it is that I will cry. And cry and cry and cry and not be able to stop. Humiliate myself even further. So when I think about all that, going to a doctor seems a big risk and more of a risk than maybe having a DVT or having something seriously wrong.

This locum GP was really nice to me and didn’t once mention my weight or say anything at all about my size. I think if I’d been thin she wouldn’t have said or done anything differently. I probably wouldn’t have been in tears twice because I was so overwhelmed and freaked out about her even looking at me though. Reading fat acceptance blogs, tumblrs, etc, has been great for me in a lot of ways but I think it’s made me even more anxious about what might happen because I’ve heard so many bad things that have happened to people just like me. If I hadn’t read those stories then I’d feel a lot worse about what had happened to me I suppose. So maybe I should try to go and see my GP more often so I don’t get so anxious when I have to see him (or a locum) for something important. Haha, just read that back and realised I’m not counting my mental illness problems as important.

I’ve got an appointment with the crisis team nurse tomorrow and I think she’ll discharge me. It’s the third time I’ve had the crisis team this year. Or the fourth, I can’t remember. The last two times have been really helpful and I’ve felt the difference. But I can also feel myself starting to feel dependant on the nurse visits and worrying that I won’t be okay without them. I’m not attached to any of the nurses in particular, though the last two have been great, but it’s more the idea of “it’s okay that I feel so bad now because I can hold out for another three or four days or whatever until the next appointment”. That seems a bad path to be on. Most of me wants to be fucking free of all this and I can’t be until I’m okay enough on my own, or at least on my own most of the time. I’ve also just acquired a social worker somehow (I thought it was a one-off visit to do an assessment [personalisation?] to see if I ‘officially’ needed more support but she’s saying she’ll see me again, don’t feel like I can say anything about it) who has referred me to another support service. So that’s even more. I’m too proud as well. I don’t want to see myself as some kind of complete loser who has an empty life but I know my life is pretty empty compared to most people and it’s not like I like my life at all. I don’t want all this. I don’t want to be ill. I want to be free.